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Individual

JAMES KIMO JANDOC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OMT, LMT, STMS

Contact information

Practice address
1610 GROVER ST STE C3, LYNDEN, WA 98264
(360) 510-4630
(360) 935-9731
Mailing address
1610 GROVER ST STE C3, LYNDEN, WA 98264-1539
(360) 510-4630
(360) 935-9731

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA00015681
WA
225700000X
Massage Therapist
MA00015681
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0152465
WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRY
WA
Enumeration date
09/16/2010
Last updated
05/09/2025
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